Get documents about "Permission to Obtain Information Employee
Description
Permission to Obtain Information Employee document sample
Document Sample
INSTRUCTIONS - PLEASE READ
University of Southern Mississippi
DOMESTIC TRAVEL ONLY
This workbook will contain all of the forms necessary to get approval and file for reimbursements
on a trip. By combining all forms in one book, it should be easier to keep corresponding records
together. Start a new workbook for each trip.
START A NEW WORKBOOK FOR EACH TRIP
By starting a new workbook for each trip, you will have the most current form
reflecting updates in policies as well as rates for mileage.
Tab Legend for Different Forms
PTT Permission to Travel
TR ADV AGMT Travel Advance Agreement
REG-CK Registration Check Request
TV Travel Voucher
MTM Multi Trip Mileage
BREF Business Related Expense Form
The information entered on the "Start Here" page will be used to auto-
populate each of the forms in this workbook.
This will save data entry time.
HINT: Use the TAB key to move from field to field on all sheets,
instead of the mouse.
Proceed to the tab called "Start Here" if you are ready to continue
University of Southern Mississippi
Official Permission to Travel and Reimbursement Forms
This workbook will contain all of the forms necessary to get approval and file for reimbursements on a trip. By
combining all forms in one book, it should be easier to keep corresponding records together. Start a new workbook
for each trip.
Tab Legend for Different Forms
PTT Permission to Travel (All Conf, Conventions, Associations, and Meetings)
TR ADV AGMT Travel Advance Agreement (Required for all advances)
REG-CK Registration Check Request (For Univ to cut a check to the vendor)
TV Travel Voucher (To be Reimbursed before and after trip)
MTM Multi Trip Mileage (Driving to lots of different locations)
BREF Business Related Expense Form (Entertainment)
Description Enter your information below
Enter Data to the
The individual being paid on this form must be an employee of the University of
right>>>>>>>>>
Southern Mississippi. An employee is someone that receives bi-weekly, monthly or
single payment payroll checks from USM. If the individual received a check from A/P for
services, then they are not an employee of USM and reimbursements should be done on
a Remittance Voucher.
EXCEPTIONS:
USM Grad students must complete travel forms for reimbursement of any travel
(required by State).
Undergrad students can be reimbursed by AP when expensed on your budget as
DO NOT SEND
Contractual Services or by Travel when expensed on your budget as Travel.
THIS PAGE TO
Name
TRAVEL - KEEP
USM Empl ID
FOR YOUR
(FIRST PYMT ONLY) SS#
RECORDS E-Mail
Phone #
Dept Box #
Dept Name
University Standing Faculty, Staff, PI, Student
Fund (5 digits)
CHARTFIELD
Dept ID (6 digits)
Program (5 digits)
Project /Grant
MAX AMOUNT ALLOWED
Fund (5 digits)
CHARTFIELD
Dept ID (6 digits)
Program (5 digits)
Project /Grant
MAX AMOUNT ALLOWED
Employee name completing form
submitting
Person
E-Mail employee completing form
Phone # employee completing form
Beginning Date of Trip(mm/dd/yr)
Ending Date of Trip(mm/dd/yr)
Title of Meeting
(Do not abbreviate)
Select a purpose from drop down box
Purpose of trip:
CHECK WITH DEPARTMENT HEAD TO SEE IF A MEMO IS REQUIRED FOR MORE INFORMATION ON
REQUIRED BY STATE
PURPOSE OF TRIP.
Location of Visit:
(City and State)
REQUIRED BY STATE
Accompanied By:
DO NOT SEND THIS PAGE TO TRAVEL - KEEP FOR YOUR RECORDS
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: START HERE 2 of 15 12:11 PM
INSTRUCTIONS FOR COMPLETION THE PERMISSION TO TRAVEL FORM
Field Description / Instruction
Date Submitted Date you complete the form and send it to the Travel Office
Person completing form ENTERED ON START HERE TAB Name of person completing form
Phone number ENTERED ON START HERE TAB Phone of person completing form
E-Mail address ENTERED ON START HERE TAB E-Mail Address of person completing form
Employee ENTERED ON START HERE TAB Enter Employee/Travelers Name
University Classification ENTERED ON START HERE TAB Title of person traveling - Faculty, PI, Student, Grad Student, etc
Employee's E-Mail Address ENTERED ON START HERE TAB E-Mail Address of Employee traveling
Phone # ENTERED ON START HERE TAB Phone number of the person traveling or a contact number of someone in the department
Empl ID # ENTERED ON START HERE TAB Employee ID - located on payroll check or contact HR for number
Student's SSN ENTERED ON START HERE TAB Students Social Security Number - REQUIRED
Department Name ENTERED ON START HERE TAB Department that the Employee/Travelers works in
Department Box # ENTERED ON START HERE TAB Department's mail box
Dates of Travel ENTERED ON START HERE TAB Day you leave, day you return
Title of Meeting ENTERED ON START HERE TAB Do not Abbreviate
Location of Meeting ENTERED ON START HERE TAB Where Conf or Meeting is taking place and city and state where meeting is being held
Purpose of Travel ENTERED ON START HERE TAB Why are you attending this meeting, conference, etc.
Estimated Expenses Fill in your estimated expenses for each area that is applicable
Check the USM Travel Website for the most current State Contract on which Rental Car Agency to use.
Rental Car and Gas
Original receipts are always required.
Advances are not paid to USM Employees.
Request for Advance
See Travel Policy for exceptions
Registrations are pre-paid by the Employee and can be reimbursed on a Travel Voucher prior to the trip or after the employee has
traveled along with other expenses.
Registration Fees
See Travel Policy for exceptions
Signatures
Signature of Traveler The Employee/Traveler must sign the form
Chair or Next Higher Expenditure
REQUIRED on all travel - BE SURE YOU HAVE THE EXPENDITURE AUTHORITY SIGNATURE
Authority
Print signature of expenditure Print the signature of the person that has expenditure authority over the Chartfield - REQUIRED
authority Program Adm
Sponsored Required if using restricted funds
Vice President Required for Foreign, Hawaii, Canada, and Mexico Travel - See International Travel Forms
President Required for Foreign, Hawaii, Canada, and Mexico Travel - See International Travel Forms
Must be completed before travel is approved; if more than one Chartfield is used indicate amount for each Chartfield. If more than 2 Chartfield
Chartfield Information
are used, please attach a memo - be sure to have signature authority for all Chartfield.
SPECIAL CONSIDERATION NOTES:
Restricted fund accounts require the Project Director's signature
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: PTT Instr 3 of 15 12:11 PM
THE UNIVERSITY OF SOUTHERN MISSISSIPPI Date Submitted August 2, 2011
ADVANCES DUE BEFORE:
http://www.usm.edu/procurement/travel.html
Person Completing Form:
PERMISSION TO TRAVEL
Submit at least two weeks prior to travel dates Phone Number
DOMESTIC TRAVEL ONLY e-mail
Employee Name Go to Start Here Tab to complete USM Empl ID
University Classification Faculty, Staff, PI, Student Student SSN (required)
Traveler's E-Mail Address Department Name
Phone # Department Box #
Title of Meeting
Location of Meeting
MEMO MAY BE
Purpose of Travel Select a purpose from drop down box
REQUIRED BY DEPT.
Undetermined, Travel Ending Date Missing
Dates of Travel Beginning Date Ending Date
(include traveling dates)
ESTIMATED EXPENSES: REQUEST FOR EXCEPTION ADVANCE (Attach Advance Agreement)
Meals Request when submitting this form 3 weeks prior to travel.
Hotel Lodging Max. Allowed (80%) $ -
Mileage Amount Requested ---> $ -
Airfare STATE LAW PROHIBITS CASH ADVANCES FOR TRAVEL
Rental Car and Gas WITHIN THE STATE
Other Trans (taxi,shuttle,etc) IF REGISTRATIONS ARE TO BE PAID BY USM
Registration Fee Any registration paid by USM for an employee must be
Other Expenses OVER $750.00. Submit to the Travel Office on a Registration
(over $100 attach list)
Check Request Form with a Permission to Travel attached at
Total Estimated Expenses $ - least 4 weeks prior to the due date to allow for processing of
MAXIMUM ALLOWED AMOUNT $ - check*.
SIGNATURES 4) *Sponsored Programs Adm Date
(if restricted funds are expended - Box 5157 )
By signing I acknowledge that I have read and
understand the University Travel Policy
1) Signature of Traveler Date 5) USM Travel Coordinator Date
2) *Chair or Next Higher Expenditure Authority Date 6) **Vice President Date
TYPE signature name here =>
3) **Dean's Signature Date 7) **President/or Designee Date
TYPE signature name here =>
*Required for Domestic Travel; **Required for Foreign, Hawaii, Canada, and Mexico Travel
Where is the money coming from? Chartfield(s) required below
MAXIMUM ALLOWED FROM CHARTFIELD 1 $ - MAXIMUM ALLOWED FROM CHARTFIELD 2 $ -
/ / / / / /
CHARTFIELD - Fund/Dept-ID/Program/Proj-Grant CHARTFIELD - Fund/Dept-ID/Program/Proj-Grant
For University Travel Coordinator Use only
Travel Authorization Number Exception Reason:
Open Item Voucher Number
Date Submitted for OI Processing
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: PTT 4 of 15 12:11 PM
Date August 2, 2011 USM Empl ID
THE UNIVERSITY OF SOUTHERN MISSISSIPPI Name
TRAVEL ADVANCE AGREEMENT Phone # Dept Box #
E-Mail
Dept Name
The maximum amount that can be advanced is 80 percent of the estimated cost of the trip less any expenses prepaid or
charged to the university (registration fees, airline tickets, hotel deposit).
The Advances are to be repaid by the employee with the submission of a Travel Voucher.
Outstanding Travel Advances:
• Travel Advances are due within 15 days after return from trip.
• If the employee is past due a second time, the employee will be ineligible for future advances for a period of one year. Any travel during that year will be on a “reimbursement only”
basis.
• If an employee has had their eligibility for advances revoked and then reinstated, any further revocation will be permanent.
• If it should become necessary to do a deduction from your payroll check, the employee will not qualify for future travel advances. The deduction instituted will be the amount of the
outstanding Travel Advance, not to exceed one-half of the employee's net pay. This deduction will continue until the outstanding Travel Advance is settled by the Travel Office.
• Outstanding Travel Advances not only include instances when an Employee Travel Voucher has not been submitted to the Travel Office but also when reimbursable expenses
processed on an Employee Travel Voucher are less than the Travel Advance received.
• Do Not Send CASH in Campus Mail! If cash is sent through campus mail and the funds are lost, the employee will remain
responsible for the balance of the unspent advance funds.
Returned Check Policy
When an employee submits a check to cover an amount due from an advance and the check is returned to USM by the bank because of insufficient funds, the
employee will not qualify for future travel advances.
Amount Requested $0
End Date of Trip
Travel Voucher Due Before Undetermined, Travel To avoid Payroll Deduction
Ending Date Missing
I have read the above policy regarding Travel Advances and by signing below I understand any part of the advance that I receive today that is still
outstanding 15 days from the end date of this trip will be payroll deducted, not to exceed one-half of my net pay, at the next available pay period. If
payroll deducted, I undertand that I will be ineligible for future advances.
Signature:______________________________________________________________________Date:_________________
Additional Signature (if required):______________________________________________________________________Date:_________________
IF REQUESTING AN ADVANCE, THIS FORM MUST BE ATTACHED TO THE PERMISSION TO TRAVEL 8/2/201112:11 PM
INSTRUCTIONS FOR REGISTRATION CHECK REQUEST
TO INSURE THAT PAYMENT IS RECEIVED ON TIME, SUBMIT TO THE TRAVEL OFFICE 4 WEEKS BEFORE DUE DATE. This will allow time for a W9 to
be obtained and the vendor to be set up in the system as a vendor.
Name of Vendor -
VENDOR
DO NOT ABBREVIATE THE NAME Employees are reimbursed on a Travel Voucher
ADDRESS TO WHICH CHECK
SHOULD BE SENT Address that the check should be sent to
**Telephone Telephone number of the vendor Will expedite the process of getting a W9 - and getting a check processed.
**Fax Number Fax number of the vendor Will expedite the process of getting a W9 - and getting a check processed.
Registration Due Date What the due date is for the check to be received by the vendor - VERY IMPORTANT.
Special Instructions: Note any special instructions for check processing
A COPY OF THE PERMISSION TO TRAVEL MUST BE ATTACHED FOR ALL INDIVIDUALS
HINT - attach your completed Registration Check Request to your Permission to Travel when
submitting it for approval.
REGISTRATION CHECK REQUEST
THE UNIVERSITY OF SOUTHERN MISSISSIPPI
A COPY OF THE PERMISSION TO TRAVEL MUST BE ATTACHED FOR ALL INDIVIDUALS REQUESTING REGISTRATION PAYMENTS
VENDOR ID DATE August 2, 2011
VENDOR DEPARTMENT
NAME
DO NOT ABBREVIATE THE NAME OF THE VENDOR
DEPT BOX
ADDRESS TO WHICH CHECK PERSON COMPLETING FORM
SHOULD BE SENT
NAME
TELEPHONE # OF VENDOR
E-MAIL
FAX # OF VENDOR
PHONE #
REGISTRATION DUE DATE EMPLOYEE
NAME(S)
If the registration is due before August 30, 2011 we cannot guarantee that the check will arrive in time. You need to allow 4 weeks
for the check to be processed. This will allow for required signatures, setting up the vendor and processing the check.
If a W-9 is not attached the Telephone Number and Fax Number are required. Payment cannot be made until a W-9 has been received.
DESCRIPTION AMOUNT
$ -
ATTACH: PTT and Registration form for all individuals
TOTAL $ -
Special Instructions:
I do solemnly affirm that the amounts scheduled above are just and true in all respects and were expended for The University of Southern Mississippi's purposes.
Requested By Date
Approved By Date
Sponsored Prog Adm Date
(If required - send to 5157)
PROJECT/GRAN
FUND DEPTID PROGRAM
ACCOUNTING USE ONLY ACCOUNT T AMOUNT
(5 digets) (6 digets) (5 digets)
(7 digets)
VOUCHER NUMBER
$ -
$ -
VOUCHER DATE
$ -
$ -
PROCESSED BY:
$ -
$ -
TOTALS BALANCE READY TO PROCESS
A COPY OF THE PERMISSION TO TRAVEL MUST BE ATTACHED FOR ALL INDIVIDUALS
REQUESTING REGISTRATION PAYMENTS
8/2/2011
Rev 10/2008
Instructions for Travel Voucher
Fill in ALL requested information about traveler on the Start Here Tab.
TO EXPEDITE THE REIMBURSEMENT, BE SURE TO COMPLETE ALL THE REQUESTED INFORMATION AND TO ATTACH ALL REQUIRED RECEIPTS
BE SURE TO ATTACH A COPY OF YOUR PERMISSION TO TRAVEL TO YOUR TRAVEL VOUCHER
Expense Reimbursement Allowed Documentation Required
Meals Actual charges not to exceed No receipts required. State
the maximum meal allowance does not allow reimbursement of meals for a day trip.
for the area traveled in - See Be sure to reference if lodging was paid for by someone else otherwise we can not
Website for per-diem allowed. reimburse for meals.
Lodging Actual Charges based on a An original itemized receipt is required. IF ATTENDING A CONFERENCE a copy of the
single rate conference literature showing the conference hotel and rate or a copy of the registration
form which includes the housing reservation MUST BE ATTACHED to the Travel Voucher
in order to be reimbursed.
Personal Vehicle See Website for mileage NOTE: One line must reference the mileage from city to city. IF you have around town
reimbursement rate driving, you must enter another line with that information.
Airline Travel Actual Charges Airline E-Ticket reflecting payment, Passenger Receipt reflecting payment required
Rental Car/Bus/Train Actual Charges Original receipt.
OTHER EXPENSES - Pick the ones applicable to your trip from the drop down box
Registration Fees Actual Charges Original receipt, copy of personal check or a copy of credit card statement showing payment.
Original receipt.
Rental Car Actual Charges Check the USM Travel Website for the most current State Contract on which Rental Car
Agency to use.
Rental Car Fuel Original receipts for fuel required
Group Banquet Fee Actual Charges Original receipt
Original receipts if charges are in excess of $10.00. The University allows $10.00 for day of
Taxi/Shuttle/Limousine - to airport Actual Charges departure and $10.00 for day of return. The State does not allow reimbursement for taxi service to
and from a restaurants. If more than 2 taxi receipts, an explanation is required.
Original receipts if charges are in excess of $10.00. The University allows $10.00 for day of
Taxi/Shuttle/Limousine - from airport Actual Charges departure and $10.00 for day of return. The State does not allow reimbursement for taxi service to
and from a restaurants. If more than 2 taxi receipts, an explanation is required.
Original receipts if charges are in excess of $10.00. The University allows $10.00 for day of
Taxi/Shuttle/Limousine - other Actual Charges departure and $10.00 for day of return. The State does not allow reimbursement for taxi service to
and from a restaurants. If more than 2 taxi receipts, an explanation is required.
Telephone USM BUSINESS CHARGES ONLY State will not reimburse for personal calls made during travel
Motel Room Internet Charges Actual Charges Original receipt
Original receipts if charges are in excess of $10.00. The University allows $10.00 for day of
Tips (baggage handling - $1 per bag) Actual Charges
departure and $10.00 for day of return.
Parking Actual Charges Original receipts if charges are in excess of $10.00.
Tolls Actual Charges Original receipts if charges are in excess of $10.00.
Other Expenses Not referenced in drop down box - lines available to type in other expenses
SOME EXPENSES NOT paid by travel - Dues, abstracts, supplies, printing, personal calls.
Contact the Travel Office if you have a question on what to send for reimbursement.
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: TV Instr 8 of 15 12:11 PM
Instructions for Travel Voucher
Total Expense Total Requested for reimbursements
Less Advance Less any advances or reimbursements already made
Total Reimbursed Total of reimbursement check
Max Reimbursed If the department sets a specific reimbursement amount, the figure should go here
Employee Signature Employee signature
Chair or Next Higher Expenditure
Signature required
Authority
Print Signature Print signature of chair or next higher expenditure authority REQUIRED
Sponsored Program Adm If restricted account, must be approved by Sponsored Program Adm
Print Signature Print signature of contracts & Grants
ADDITIONAL INFORMATION
Additional Comments to explain
Add a memo
travel expense
INTERNATIONAL TRAVEL MUST ATTACH DOCUMENTATION OF EXCHANGE RATE USED. ALL RECEIPTS MUST BE CONVERTED TO US CURRENCY
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: TV Instr 9 of 15 12:11 PM
THE UNIVERSITY OF SOUTHERN MISSISSIPPI - EMPLOYEE TRAVEL VOUCHER
Faculty, Staff, PI,
Date August 2, 2011 Name Go to Start Here Tab to complete Student
Phone # E-Mail
USM Empl # Dept Name
SS# Permission to Travel Filed (if yes, attach copy) Yes (or) No
Dept Box # Submitter
Location Accompanied By:
Purpose of trip: Select a purpose from drop down box
Title of Meeting:
PERSONAL MEALS AND LODGING (LODGING REQUIRED FOR MEAL REIMBURSEMENT)
*"If you did not pay for lodging reference who did or whom you stayed with " DO NOT leave Lodging blank.
Date
Business or
Breakfast $ -
Group meals
Lunch $ -
use BREF
Dinner $ -
Total Meals $ - $ - $ - $ - $ - $ - $ - $ $
- -
Lodging Cost* $ - $ -
Note: for additional days, use tab TV pg2 Total Meals & Lodging $ -
TRAVEL BY PERSONAL VEHICLE
Did you use a University vehicle? Yes (or) No Be sure to confirm mileage with Rand McNally before sending.
Date From - City, State To - City, State Miles Rate TOTAL
N/A $ -
N/A $ -
N/A $ -
Note: for more mileage, use either tab Multi Trip Mileage (or) TV pg2 Total Travel By Personal Vehicle $ -
TRAVEL BY PUBLIC CARRIER (Mode = Airfare, Bus, Train, etc)
Date From To Mode Ticket Amt
Note: for additional Public Carriers, use tab TV pg2 Total Travel By Public Carrier $ -
OTHER EXPENSES (For additional other expenses, use tab TV pg2)
Item Date Place Where Expenses Were Incurred Amount
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
$ -
ADVANCE RECEIVED? Yes (or) No Total Other Expenses $ -
By signing, I certify that the above amounts claimed for travel expenses are true and accurate. Total for this page $ -
Employee Signature Chair or Next Higher Expenditure Authority Total for TV pg2 $ -
Print Signature Name below Print Signature Name below Total for Multi Trip Mileage $ -
Total for BusRelated Exp $ -
TOTAL ALL EXPENSES $ -
Sign & Date above Sign & Date above LESS ADVANCE $ -
Sponsored Prog Adm Sign & Date
(If restricted - send to Box 5157)
TOTAL REIMBURSED $ -
CHARTFIELD INFO
MAX REIMBURSED $ -
AMT DUE USM $ -
CHARTFIELD INFO
ACCOUNTING USE ONLY Fund Dept ID Program Proj/Grant Account Expense
Voucher No.
Journal Voucher #
ALLOW TWO TO THREE WEEKS FOR PROCESSING BEFORE CONTACTING THE TRAVEL OFFICE 8/2/2011
12:11 PM
THE UNIVERSITY OF SOUTHERN MISSISSIPPI - EMPLOYEE TRAVEL
Page 2
Faculty, Staff, PI,
Date August 2, 2011 Name Go to Start Here Tab to complete Student
Phone # E-Mail
USM Empl # Dept Name
Permission to Travel Filed (if yes, attach copy) Yes (or) No
Dept Box # Submitter
MEALS AND LODGING
Date
Breakfast
Lunch
Dinner
Total Meals $ - $ - $ - $ - $ - $ - $ - $ - $ -
Lodging $ -
TOTAL $ -
TRAVEL BY PERSONAL VEHICLE
Did you use a University vehicle? Yes (or) No
Date From (City, State) To (City, State) Miles Rate TOTAL
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
Note: for additional mileage, use tab Multi Trip Mileage Total Travel By Personal Vehicle $ -
TRAVEL BY PUBLIC CARRIER (Mode = Airfare, Bus, Train, etc)
Date From To Mode Ticket Amt
$ -
$ -
$ -
$ -
Total Travel By Public Carrier $ -
OTHER EXPENSES
Item Date Place Where Expenses Were Incurred Amount
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
Select an expense from drop down box $ -
$ -
$ -
$ -
$ -
Total Other Expenses $ -
TOTAL EXPENSES FOR THIS PAGE $ -
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: TV pg2 12:11 PM
Instructions for Multiple Trip Mileage Report
Fill in ALL requested information about traveler.
Be sure to reference if the traveler is faculty/staff or a student!!
Item Description / Instruction
Date Date of trip
From City, State - only
To City, State - only
Mileage See Website for mileage information
Amount Form will calculate amount
NOTE: One line must reference the mileage from city to city.
If you have around town driving, you must enter another line
with that information.
Example
Date From To Miles
4/15/2005 Hattiesburg Jackson 92
4/15/2005 Additional driving in 10
Jackson
Use: (RT) Roundtrip
(OW) One Way
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: MTM Instr 12 of 15 12:11 PM
USM Empl
Date August 2, 2011
ID
Traveler's
Go to Start Here Tab to Complete
THE UNIVERSITY OF Name
SOUTHERN MISSISSIPPI Phone # Dept Box #
MULTIPLE TRIP MILEAGE
E-Mail
REPORT
Dept Name
Submitter
UNIVERSITY CLASSIFICATION Faculty, Staff, PI, Student
ATTACH TO A TRAVEL VOUCHER
TRAVEL BY PERSONAL VEHICLE
Did you use a University vehicle? Yes (or) No USE: (RT) Roundtrip (OW) One Way
Date From - City, State To - City, State Miles Rate TOTAL
EXAMPLE - AROUND TOWN MILES ON SECOND LINE
7/1/11 Hattiesburg, MS Jackson, MS (RT 180 0.510 $ 91.80
7/1/11 Around Town 10 0.510 $ 5.10
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
N/A $ -
TOTAL TRAVEL BY PERSONAL VEHICLE $ -
By signing, I confirm that the above amounts claimed for travel expenses are true and accurate.
See instructions on how to complete
Employee Signature/Date
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: Multi Trip Mileage 13 of 15 12:11 PM
Instructions for completion of the Business Related Expense Form
"Attach to aTravel Voucher and
Send to Accounts Payable - Box 5104
To expedite reimbursements for entertainment be sure to review the Entertainment Policy for
USM before incurring the expense. The Entertainment Policy is located at -
http://www.usm.edu/procurement/apentertain.html
Item Description / Instruction
Date Date form completed
Phone # Phone number to call for questions
Name Name of employee to be reimbursed
E-Mail E-mail of employee being reimbursed
Dept Name Department Name
USM Empl ID Empl ID of employee being reimbursed
Dept Box # Department Box Number
The attached receipts had no alcoholic beverages
purchased on them________ (Initials of person MUST BE INITIALED
requesting reimbursement-REQUIRED)
Date, Time and Place of Entertainment Date the expense was incurred.
City and State where meal took place
Statement of purpose for the expense as well as
the benefit to the University (General phrases
such as Entertainment Expenses" and "Business
Explain the purpose of the activity - attach additional page if necessary
Lunch" are not adequate explanations and will be
returned, thereby delaying reimbursement)
Names of Individuals involved Name of all individuals that expense was for
ENTERTAINMENT OUTSIDE HATTIESBURG, MS Attach to a Travel Voucher and turn into Travel
ENTERTAINMENT IN HATTIESBURG, MS Attach to a Remittance Voucher and turn into Accounts Payable
The State of Mississippi does not allow us to reimburse for alcoholic beverages purchased. You
need to initial the Business Related Expense Form acknowledging that no alcoholic beverages
were purchased.
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls 8/2/2011
Tab: BREF Instr 14 of 15 12:11 PM
Date August 2, 2011 USM Empl ID
THE UNIVERSITY OF SOUTHERN MISSISSIPPI Name Go to Start Here Tab to Complete
BUSINESS RELATED EXPENSE FORM Phone # Dept Box #
E-Mail
Dept Name
This form must be completed when business entertainment expense has been incurred for the University.
Attach all original itemized receipts to this form and attach to a Travel Voucher or Employee Reimbursement Voucher
The attached receipts had no alcoholic beverages purchased on them. _________ (Initials of person requesting reimbursement-
REQUIRED)
1. Date, Time and Place of Entertainment
2. Statement of purpose for the expense as well as the benefit to the University (General phrases such as Entertainment Expenses" and "Business Lunch" are not adequate
explanations and will be returned, thereby delaying reimbursement)
3. A list of all persons in attendance, including their relationship to the program to be benefited as well as any other relevant details.
Whenever feasible, USM employees traveling together should pay for their own meals. This will cut down on the possibility of
duplicate charges to the budget used for reimbursement. Signature authorities should verify that full per-diem is not being paid to
one of the guests referenced above on their Travel Voucher.
TOTAL $ -
MUST BE ATTACHED TO THE EMPLOYEE REIMBURSEMENT VOUCHER OR
IF THERE IS TRAVEL INVOLVED ATTACH TO THE TRAVEL VOUCHER
8/2/2011
12:11 PM
File: aa30ffe2-0c41-40cd-9fe2-6d78e8f86800.xls REV 10/2008
Tab: BREF
